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Programming for Client Empowerment: Defining Assent and Trusting Client Choice |
Monday, May 27, 2024 |
8:00 AM–9:50 AM |
Convention Center, 200 Level, 202 AB |
Area: PCH/CBM; Domain: Translational |
Chair: Jessica Emily Graber (Nationwide Children's Hospital; The Ohio State University ) |
Discussant: Abraham Graber (The Ohio State University) |
CE Instructor: Abraham Graber, Ph.D. |
Abstract: This symposium presents four exemplars of conceptual considerations and/or methodological approaches to honoring client choice within therapeutic and educational programming. Specifically, two papers explore the meaning of assent within applied behavior analysis (ABA): one presents a potential experimental approach to defining the capacities for providing assent, and the other introduces an ongoing study which seeks to measure the state of the field in terms of assent-based practice. The third paper presents clinical applications of the constructional approach (Goldiamond, 1979; Layng et al., 2021), itself an assent-based system, within a tertiary-level, complex behavior outpatient clinic. The fourth and final paper discusses potential risks of the pathologization of particular types of play exhibited by autistic youth and presents a call-to-action for a more inclusive, flexible, and developmentally-sensitive approach to play. Collectively, these talks explore critical concepts for navigating the pivotal territory at the intersection of ABA and the neurodiversity movement. The symposium will conclude with a discussion of the ways in which behavior analysis can embrace neurodiversity, empower clients, and continue to apply the principles of ABA to promoting quality of life, in an ever-evolving landscape. |
Instruction Level: Intermediate |
Keyword(s): Assent, Constructional Approach, Neurodiversity, Nonlinear Contingencies |
Target Audience: Necessary prerequisites include: - an awareness of the neurodiversity movement - awareness of the topic of assent - experience with applying and/or solid conceptual understanding of the principles of ABA - exposure to the BACB ethics code |
Learning Objectives: At the conclusion of the symposium, participants will be able to: 1) acknowledge the importance of the concept of assent in ethical practice; 2) identify complexities and/or challenges of measuring and utilizing assent in practice, 3) discuss the ways in which nonlinear contingency analyses differ from or expound upon a more basic 3-term contingency formulation; and 4) discuss the ways in which providers may pathologize play in some early-intervention programs and alternatives to this approach |
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Effects of Modeling and Exposure on Responding: A Translational Study of a Prerequisite to Assent |
(Applied Research) |
JESSICA DETRICK (Western Michigan University ) |
Abstract: Assent can be defined as an individual’s affirmative agreement to participate and should be obtained by those who cannot consent (i.e., children and adults deemed as “incapable”) when conducting research or client services. Morris et al. (2021) determined that there are few procedures documented for obtaining assent from populations with limited communication. They proposed implementing a concurrent chain procedure for these participants. However, to make it likely participants can discriminate treatment options in concurrent chain, participants are typically exposed to the procedures. The skill of discrimination can be conceptualized as a prerequisite skill for providing assent. An alternative to direct exposure to the proposed treatment is, instead, to allow participants to indirectly experience each option through observing a model. In this presentation, I will describe a translational study that evaluated whether modeling intervention options produced discriminated responding. We hypothesized that some participants would display discriminated responding, but others would not. For those who did not, an exposure condition was introduced where the participants experienced the contingencies. We will then determine whether these procedures produced discriminated responding. Implications for measuring discriminated responding in the context of assent will be discussed. |
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A Survey of Professionals' Perception and Practice Related to Assent and Assent Withdrawal in Applied-Behavior-Analysis-Based Service Delivery |
(Service Delivery) |
KAIYUAN ZHU (University of Minnesota), Jennifer J. McComas (University of Minnesota) |
Abstract: Although assent has gained more and more attention in the realm of applied behavior analysis, there is no universally acknowledged definition of this concept (Breaux and Smith, 2023), nor specific guidelines for practitioners to follow, particularly in the field of service delivery. We have developed a survey to understand practitioners’ perception and practice related to incorporating direct service receivers’ assent in daily service delivery. The survey is designed to examine the influence of practitioners’ training, educational background, working history, area of professional licensure, and their direct service receivers’ characteristics on their attitude, knowledge, and practice pertaining to assent and assent withdrawal in service delivery. We will present the results of the survey and discuss potential barriers practitioners face in honoring assent and assent withdrawal when interacting with their direct service receivers, as well as practical guidelines to optimize the opportunities for the direct service receiver to exercise their right to assent and withdrawal of assent. |
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Constructional Approach to Addressing Severe Problem Behavior for Children and Their Families |
(Applied Research) |
KATHERINE GIBSON (Nationwide Children's Hospital), Jessica Emily Graber (Nationwide Children's Hospital), Christin A McDonald-Fix (Nationwide Children's Hospital, The Ohio State University, Ball State University) |
Abstract: Families with autistic children demonstrate higher risk factors than families without autism, and that level of risk is further and positively correlated with the severity of behavioral challenges experienced within the family system (e.g., Brassard, 2021; Cheng & Lai, 2023; Davis & Carter, 2008). The constructional approach and non-linear contingency analysis described by Goldiamond (1975) provides a unique lens to assessing complex contingencies and has demonstrated success when applied within clinical contexts across psychiatric populations (Goldiamond, 1979; Layng et al., 2021; Merley & Layng, 1976). This presentation demonstrates case examples of analyses and interventions applying the constructional approach and non-linear analysis to intensive parent interventions of children with severe and complex behavioral disorders served within Nationwide Children’s Hospital’s Complex Behavior Program. Clinical data demonstrate that when this case conceptualization and analysis is applied across multiple clients and family systems with various presenting severe behavioral concerns, matrix resolution can be reached for positive, socially valid outcomes for children and their families. The constructional approach applies a compassionate and assent driven case conceptualization that factors in multiple maintaining contingencies within the patient’s learning history and context, and drives change directed by the client and their families (Abdel-Jalil et al., 2023; Scallen & Ruiz, 2023). The constructional parent training program discussed in this presentation works to teach parents to apply and design problem solving strategies using non-linear analyses and intervention to solve environmental challenges associated with their children’s ongoing behavioral needs, increasing confidence and reducing dangerous behaviors, factors also associated with decreased parental stress (Miranda et al., 2019). |
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What is the Function of Play? An Assessment of the Pathologization of Play in Autistic Individuals |
(Service Delivery) |
ASHLEY SHOWALTER (Nationwide Children's Hospital) |
Abstract: Play has been observed across species and cultures (Pellegrini, 2011) and has been theorized to function for a variety of reasons including fostering social, cognitive, and emotional development in children (e.g., Ginsburg, 2007; Tamis-LeMonda, Shannon, Cabrera, & Lamb, 2004; Zhao & Gibson, 2003). While the exact definition of play has not been agreed upon (Sutton-Smith, 1996), most researchers identify play as being spontaneously initiated and naturally reinforcing to the individual (Knox, 2008; Moore & Lynch, 2017). While a child who engages in play is given the freedom to follow what is motivating to them, autistic children are not often afforded the same freedom (Yoon, Goodwin, & Genishi, 2023). In fact, autistic play is often described in the literature through a deficit lens and identified as a behavior that needs fixing (e.g., Lee, Lo, & Lo, 2017), inevitably becoming the target of intervention. In this presentation we will explore the function of play and how practitioners can align treatment goals to match that function, focusing on identifying the strengths and values of the individuals they serve. Topics for future research within the field of applied behavior analysis will also be discussed. |
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